Tag Archives: Suicide Prevention Contract

Safety Plan

It was requested for me to write about having a safety plan in order. I looked all over for mine, but could not find it :) Go figure.

There are basically 2 types of Safety Plans, one is your basic Safety Plan and the other is a Suicide Prevention Contract.

The following is an example of a Safety Plan

Sample Safety Plan
Step 1:    Warning signs (thoughts, images, mood, situation, behavior) that a crisis may be developing:
1. _____________________________________________________________________________________________ 2. _____________________________________________________________________________________________ 3. _____________________________________________________________________________________________

Step 2:    Internal coping strategies – Things I can do to take my mind off my problems without contacting another person (relaxation technique, physical activity):
1. _____________________________________________________________________________________________ 2. _____________________________________________________________________________________________ 3. _____________________________________________________________________________________________

Step 3:    People and social settings that provide distraction:
1. Name____________________________________________________ Phone______________________________

2. Name____________________________________________________ Phone______________________________

3. Place__________________________________________

4. Place______________________________________

Step 4:    People whom I can ask for help:
1.Name____________________________________________________ Phone______________________________ 2.Name____________________________________________________ Phone______________________________ 3.Name____________________________________________________ Phone______________________________

Step 5:    Professionals or agencies I can contact during a crisis:
1.    Clinician Name____________________________________________ Phone______________________________ Clinician Pager or Emergency Contact # _____________________

2.    Clinician Name____________________________________________ Phone______________________________ Clinician Pager or Emergency Contact # ______________________

3.    Local Urgent Care Services______________________________________________________________________

Urgent Care Services Address___________________________________________________________________ Urgent Care Services Phone_____________________________________________________________________

4.    Suicide Prevention Lifeline Phone: 1-800-273-TALK (8255)

Step 6:    Making the environment safe:
1. _____________________________________________________________________________________________
2. _____________________________________________________________________________________________

The one thing that is most important to me and worth living for is: ________________________________________________________________

“Safety Plan Template ©2008 Barbara Stanley and Gregory K. Brown, is reprinted with the express permission of the authors. No portion of the Safety Plan Template may be reproduced without their express, written permission. You can contact the authors at bhs2@columbia.edu or gregbrow@mail.med.upenn.edu.”

A link about having a Safety Plan in order.


Suicide Prevention Contract


I am not a professional. If you need immediate attention please call the crisis line 1-800-273-TALK (8255). The information I have provided above is for informational purposes only. If you want to put a Safety Plan or Suicide Prevention Plan in place, contact your medical provider and they can assist you with this.


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